Healthcare Provider Details

I. General information

NPI: 1447333497
Provider Name (Legal Business Name): HUY DAO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 05/17/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MUIR RD
MARTINEZ CA
94553-4614
US

IV. Provider business mailing address

PO BOX 4165
WALNUT CREEK CA
94596-0165
US

V. Phone/Fax

Practice location:
  • Phone: 925-372-1000
  • Fax:
Mailing address:
  • Phone: 925-412-7918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA60118
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: